HOUSING AS A FOUNDATION FOR GOOD HEALTH May 21, 2019 - - PDF document

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HOUSING AS A FOUNDATION FOR GOOD HEALTH

May 21, 2019 countyhealthrankings.org neighborworks.org

County Health Rankings & Roadmaps is a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

countyhealthrankings.org

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YOUR PRESENTERS AND FACILITATORS

Roseann Bongiovanni

Executive Director GreenRoots, Inc.

Rafael Mares

Executive Director The Neighborhood Developers

YOUR PRESENTERS AND FACILITATORS

Ali Havrilla

Action Learning Coach

Sarah Norman

Director of Healthy Homes and Communities NeighborWorks America

Joe Hinton

Action Learning Coach

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LEARNING OUTCOMES FOR TODAY

Describe the connection between housing and health Identify possible strategies to address the Drivers of Health Explore with data the connection between housing and health.

• When: Immediately following the webinar
• What: Interactive learning experience, opportunity to

share ideas and ask questions

• How: Videoconference and/or phone via Zoom
• Why: Deepen the webinar learning, allow further

exploration

JOIN US FOR MORE DISCUSSION – TODAY!

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WHY WE DO WHAT WE DO

Improve Health Outcomes

Menominee Nation 2015

WHY WE DO WHAT WE DO

Increase Health Equity

Durham, NC 2014

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Chelsea, MA 2017

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2019 KEY FINDINGS REPORT

• Explores the link between

housing and health

• Call to action to create
• pportunity and health for all
• Provides references to local data

resources, evidence-informed strategies, and examples

NeighborWorks America

Sarah Norman, Director Healthy Homes & Communities

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Evidence of the influence of housing on health

• Housing

ng qualit ity: y: Substandard housing is associated with increased morbidity, including infectious diseases, chronic illnesses. Lead, mold, indoor air pollutants, and poor heat control directly negatively affect health.

• Housing

ng affordab dabilit lity/ y/sta tabilit ility: y: Eviction, foreclosure, and other causes of housing instability are all associated with adverse health outcomes (Arcaya et al. 2013).

• Access to

to qualit ity y educati tion

• n,

, trans nspor

• rtat

tatio ion, n, and social l capital tal is limited by where one lives (Diez Roux and Mair, 2010).

• Neighb

hborho hood

• d condi

diti tion

• ns: cleaning/greening vacant lots associated with reduction in self-reported

feelings of depression and worthlessness (South et al, 2018).

• Communities of color disproportionally live in neighborhoods with high concentrations of low-quality

housing (JCHS 2016). This pattern is partly due to histo toric ical al disinvestm tment t from communities of color, causing economic ic and racia ial l segregati tion n and entrenched disparities (Shapiro et al. 2013).

• Neighborhood social

l cohesio ion n mediat ates the associatio ation n between n physic ical l dete terio ioratio ation n and mental health (Kruger et al, 2008).

Literature review drawn from Building Healthy Places: How are Community Development Organizations Contributing? by Alina Schnake-Mahl and Sarah Norman, published at Cities and Health on June 8, 2017. (View the previously-published working paper.)

How are communities addressing the shortfall in healthy, affordable housing?

They are…

• 1. Developing dedicated affordable healthy housing units
• 2. Preserving and improving affordable housing stock
• 3. Helping families access healthy homes
• 4. Protecting against displacement and improving housing quality
• 5. Improving neighborhood conditions
• 6. Leveraging housing as a platform to build social cohesion and connect to

resources and services

Informed by Local Housing Solutions, link here; Affordable Housing and Health: City’s Roles and Strategies for Progress, link here. 13 14

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Health & housing partnerships often focus on: 1) a specific population, 2) a specific place, 3) a specific housing type, or 4) a specific health concern.

Rental

• Supportive housing, e.g. “Housing First”

for persons experiencing homelessness

• Service-enriched housing for seniors
• Multi-family rental housing
• Landlord liaison or rental assistance

Home ownership

• “Doctor prescribed” home repair
• Place-based investments

Neighborhood Housing Services of Willamette

• Leveraging rental housing to promote

health by addressing housing stability, food security, community engagement, and health services navigation through a unified approach.

• InterCommunity Health Network

Coordinated Care Organization (IHC- CCO) and Willamette NHS developed a community health worker program.

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Example #2: Place-based, with a focus on substance use disorder

Project Vision n in Rutlan and, VT with

NeighborW hborWorks

• rks Western

rn Vermont mont

• Collaboration of police, social service agencies, and

housing/community development

• Designed to improve community safety, address

substance use, and build health through holistic strategies

• Three prongs, one of which seeks to intentionally

improves neighborhood conditions, community connectivity and housing

• Example: rehab of homes confiscated by the Federal

Marshalls due to drug-related criminal activity

Resources

Training Success Measures Health Outcome Tools Publications and Tools Learning Communities Symposia and Convenings NeighborWorks Network of Community Development Organizations

Symposia: 8/21/19 New Orleans, LA

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Find a NeighborWorks Network member near you

Our Network Directory is available online at: http://www.neighborworks.org/ Our-Network/Network-Directory

SHARE

What efforts are underway in your community at the intersection of housing and health?

Vicksburg, MS 2017

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CHELSEA, MA

Chelsea, MA 2017

CHELSEA HEALTH STARTS AT HOME

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ENROLLMENT

• MGH enrolled 120 caregivers and children in the HSAH

intervention.

• Eighty-four percent of the participants were Latino, 10% black,

and 6% other race/ethnicity.

• Of these families, 64% spent more than half their income on

housing, 36% were homeless in the prior year, and 29% moved two or more times in the prior year.

RESULTS

• From 2016-2018, food insecurity decreased and self-rated

physical and mental health status improved.

• At baseline, 45% of caregivers reported food insecurity, which

decreased to 14% at 12 months.

• At baseline, 3.6% of caregivers self-rated their health status as

excellent or very good, which increased to 29% at 12 months..

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HOUSING INDICATOR: QUALITY OF HOUSING

0% 10% 20% 30% 40% 50% 60% 70% 80% Excellent or Good Acceptable Poor or Very Poor Don't Know/Refused

Chelsea, MA Quality of Current Housing, by Timepoint

Baseline (N = 56) 6-Month (N=56) 12-Month (N=56)

Source: The Boston Foundation Health Starts at Home Initiative. Quarterly Evaluation Memo. November 30, 2018

HOUSING INDICATOR: SATISFACTION WITH CURRENT HOUSING

0% 10% 20% 30% 40% 50% 60% 70% 80% Very satisfied or Satisfied Neutral Dissatisfied or Very Dissatisfied Don't Know/Refused

Chelsea, MA Satisfaction with Current Housing, by Timepoint

Baseline (N = 56) 6-Month (N=56) 12-Month (N=56)

Source: The Boston Foundation Health Starts at Home Initiative. Quarterly Evaluation Memo. November 30, 2018

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QUALITY OF LIFE INDICATOR: ANXIETY

Source: The Boston Foundation Health Starts at Home Initiative. Quarterly Evaluation Memo. November 30, 2018

0% 10% 20% 30% 40% 50% 60% 70% 80% Score ≥ 3 suggets anxiety/panic Score < normal Missing

Chelsea, MA Caregiver's GAD2 Screening Result, by Timepoint

Baseline (N = 56) 6-Month (N=56) 12-Month (N=56)

QUALITY OF LIFE INDICATOR: DEPRESSION

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Score ≥ 3 suggets depressive Score < normal Missing

Chelsea, MA Caregiver's PHQ2 Screening Result, by Timepoint

Baseline (N = 56) 6-Month (N=56) 12-Month (N=56)

Source: The Boston Foundation Health Starts at Home Initiative. Quarterly Evaluation Memo. November 30, 2018

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“It was like I was in the middle of the Indian Ocean, like I was a solo captain facing a tsunami, because I couldn’t pay rent regularly, it was very, very tough. But three months ago, I enrolled in this program and I found an apartment.“

• Gabriel Querette, CONNECT

Client

CHELSEA, MA HOUSING AFFORDABILITY

• Proximity to Boston is a blessing and

a curse

• Gentrification and rapid

displacement are impacting and already overburdened community

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We can sit back and watch it happen, or we can organize, engage and empower

• ur community to

prevent wide-spread displacement

MULTI-PARTNER ANTI-DISPLACEMENT ROUNDTABLE

CHELSEA ANTI-DISPLACEMENT ROUNDTABLE PRIORITIES

• Formalization of the Chelsea Community

Land Trust to prevent properties from being swallowed up by greedy investors.

• Anti-displacement zoning for the

neighborhoods abutting the Chelsea Creek

• Citywide advocacy for the creation of

more affordable housing in Chelsea

• Opposition to dense market-rate and

luxury housing units that are not affordable or appropriately sized for families

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CHELSEA ANTI-DISPLACEMENT ROUNDTABLE PRIORITIES

• Advocacy for Community Preservation Act

funds be invested in affordable housing

• Creation of “development principles” by

which every development in Chelsea should abide by/agree to, at the root of which will be about preserving neighborhoods and causing no further burdens or impacts, including displacement

• Local policies and ordinances for deeper

affordability, preventing condo conversations and short-term rental

EMPOWERMENT, SOCIAL CONNECTIVITY & HOUSING SECURITY ALL CONTRIBUTE TO HEALTHY NEIGHBORHOODS

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DATA

Using data to reveal the factors that influence health

Allen County, KS 2017

HEALTH & HOUSING

A safe, secure, and affordable place to call home is a foundation for good health.

Vicksburg, MS 2017

what efforts are underway in your community at the intersection of housing and health

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THE INTERSECTION OF POVERTY AND HOUSING CHILDREN IN POVERTY

Percentage of people under age 18 in poverty.

Taos Pueblo, 2014

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SEVERE HOUSING COST BURDEN

Percentage of households that spend 50% or more of their household income on housing.

Everett, MA, 2015

HOMEOWNERSHIP

Percentage of occupied housing units that are owned.

Richmond, VA, 2017

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SOLUTIONS

Make communities more inclusive and connected

Inclusive Zoning • Youth Leadership Programs

Facilitate access to resources needed to secure affordable housing

Housing Trust Funds • Housing Choice Vouchers

Addressing capital resources needed to create and preserve affordable housing

Low-Income Housing Tax Credits • Land Banks

KEY TAKE-AWAYS

• Opportunities for health vary by place

and race

• Policy played a role in creating

differences in opportunity

• Policy can play a role in undoing those

differences

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22 Dorothy Richardson and supporters in front of a home that would be rehabbed instead of torn down

• Self-directed learning on specific topics
• Blend guidance, tools, and activities for

hands-on practice and reflection

• Topics include:

– Introduction to Equity – Partnering With Residents – Getting Started With Policy Change

HIGHLIGHTED GUIDANCE: ACTION LEARNING GUIDES

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WE WANT TO HEAR FROM YOU!

Click the link to answer a few questions about today’s webinar

24:1 Community, MO, 2016

Let’s hear from you…

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• How: videoconference
• Who: YOU! (Space is limited)

DISCUSSION GROUP:

• When: Immediately following the

webinar

• What: Interactive learning experience,
• pportunity to share ideas and ask

questions

• Why: Deepen the webinar learning, allow

further exploration

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POLL: WHAT DO YOU WANT TO LEARN MORE ABOUT?

• Elements of a comprehensive housing strategy
• Housing efforts without displacement
• What can public health offer housing partners and vice-versa?
• How can partnerships be built and sustained that focus on

creating affordable housing?

STAY CONNECTED

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JOIN US FOR A DISCUSSION GROUP NOW! REGISTRATION LINK IN CHAT

THANK YOU!

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